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Generate impression based on medical findings. | Female, 82 years old. Right jugular catheter tip in the SVC with no pneumothorax or other complications.Small linear scar like opacities in the left upper lobe and no acute cardiopulmonary findings. | New catheter with no complications. |
Generate impression based on medical findings. | Female, 34 years old.Reason: balloon pump placement Left-sided ICD lead and generator in place. Right central venous catheter tip in the SVC/atrial junction.Stable cardiomegaly. Mild migration of the IABP marker into the descending aorta, which now projects approximately 3 cm from the top of the aortic arch.No large pleural effusions or pneumothorax. No focal pulmonary opacity. | Mild migration of the IABP marker into the descending aorta, which now projects approximately 3 cm from the top of the aortic arch.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | 68-year-old male her with brain lesions. Evaluate for primary tumor source CHEST:LUNGS AND PLEURA: Right upper lobe air space opacity measuring 2.7 x 2.3 cm on image number 27, series number 3 suspicious for a bronchogenic neoplasm. There is air space opacity extends to the right hilum.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Left lower pole stone. Right upper pole subcentimeter cyst.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: Prostate gland is mildly enlarged.BLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality noted | Right upper lobe soft tissue density lesion suspicious for primary bronchogenic carcinoma. |
Generate impression based on medical findings. | Female, 51 years old.Reason: Neutropenic fever, r/o pneumonia History: Fever Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities.Right subclavian and left jugular catheters terminate in the SVC. | No significant abnormality. No evidence of infection although CT would be more sensitive if the patient continues to be neutropenic and febrile. |
Generate impression based on medical findings. | Cough, please rule out pneumonia Right PICC terminates in the SVC. Low lung volumes persists although improved with diminishing basilar atelectasis. No pneumothorax or pleural effusion. | Mildly improving basilar atelectasis and improving lung volumes.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Male, 80 years old.Reason: Constipation - compare with previous imaging for LBO Chest: Status post median sternotomy. The heart size is normal. No focal pulmonary opacities, pleural effusion, or pneumothorax. Left basilar subsegmental atelectasis. LVAD is in an unchanged position. No evidence of subphrenic free air.Abdomen: Nonobstructive bowel gas pattern. Retained contrast extends to the level of the sigmoid colon without upstream bowel dilatation to suggest obstruction. No free intraperitoneal air. Slight rightward curvature and degenerative disease of the thoracolumbar spine. Gas in the bladder and evidence of soft tissue pelvic mass better characterized by CT from 6/23/2016. | No specific evidence of bowel obstruction. No free intraperitoneal air. |
Generate impression based on medical findings. | 39-year-old female complains of right upper quadrant pain. LIVER:The liver measures 15.5 cm. There is normal echogenicity of the parenchyma. No masses, ascites, or intrahepatic ductal dilatation. The portal vein is patent with normal hepatopedal flow.GALLBLADDER, BILIARY TRACT: There is an approximately 1.7 x 0.6 cm hyperechoic, dependent, shadowing foci in the gallbladder that is consistent with a gallbladder stone. No sludge or debris is seen. The gallbladder wall measures approximately 0.1 cm. There is a negative sonographic Murphy's sign. No pericholecystic fluid. The common bile duct measures approximately 0.2 cm.PANCREAS: Evaluation appears limited due to overlying bowel gas, however the visualized portions appear normal.SPLEEN: The spleen measures approximately 10.5 cm. No abnormalities noted.KIDNEYS: The right kidney measures approximately 11.9 cm. The cortex has normal echogenicity. No shadowing calculi, concerning mass, or hydronephrosis. The left kidney measures approximately 10.4 cm. The cortex has normal echogenicity. No shadowing calculi, concerning mass, or hydronephrosis.OTHER: No significant abnormality noted. | 1. Cholelithiasis as described above without signs of acute inflammation or ductal dilatation. |
Generate impression based on medical findings. | Reason: eval right pleural effusion History: as above Large right pleural effusion with almost complete opacification of the right hemithorax, and marked shift of the mediastinum to the left. A previously described left suprahilar airspace opacity is not visible on the current radiograph but may be obscured by the shifted mediastinum. A text message was sent to Dr. Newcomb at the time of reporting. | Very large right pleural effusion producing mediastinal shift and underlying atelectasis. |
Generate impression based on medical findings. | Abdominal pain. Loose screening stool. LIVER: Non-cirrhotic liver morphology. Normal parenchymal echogenicity. An 8 mm hyperechoic focus in the right hepatic lobe, favoring benign etiology such as an hemangioma. Normal portal venous blood flow and direction.GALLBLADDER, BILIARY TRACT: No biliary ductal dilation. Normal appearance of the gallbladderPANCREAS: Obscured by bowel gas.KIDNEYS: The right kidney is 10.7 cm in length, with a 2.5 cm simple appearing cyst. The renal parenchymal echogenicity is increased. No suspicious renal lesions are evident. No hydronephrosis is present.SPLEEN: Not visualized.OTHER: Ectatic aorta noted. | 1. No specific findings to account for the patient's symptoms.2. Echogenic renal parenchyma without hydronephrosis, compatible with medical renal disease. |
Generate impression based on medical findings. | Male, 81 years old.Reason: please evaluate for metastatic disease History: left kidney cancer Heart size upper normal.No significant pulmonary or pleural abnormality.No sign of metastases. | No evidence of metastases, or other significant abnormality. |
Generate impression based on medical findings. | Male, 54 years old.Prekidney transplant evaluate. End-stage renal disease. Rule out cardiomegaly or infiltrates. Normal heart size. No focal airspace opacities, pleural fluid or pneumothorax. | Normal chest. |
Generate impression based on medical findings. | Male, 81 years old.With acute dyspnea after pacemaker implant. Low lung volumes with subsegmental atelectasis. Persistent moderate cardiomegaly with worsening edema. Pacemaker leads appear unchanged. No pneumothorax. | Worsening pulmonary edema. No pneumothorax. |
Generate impression based on medical findings. | 61-year-old female with history of metastatic renal cell cancer CHEST:LUNGS AND PLEURA: Previous described nodular opacities in the left upper lobe are unchanged. Calcified granulomas in the right lower lobe are also unchanged.MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: Status post splenectomy.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Status post left nephrectomy. No evidence of recurrent disease. Right kidney is unremarkable.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small paramedical hernia containing nonobstructed transverse colon segments.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: Status post hysterectomy.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | No significant change from previous study. |
Generate impression based on medical findings. | Age: 32 yearsGender: FemaleReason for Study: Reason: persisitent cough, pregnant History: cough, right sided chest pain The cardiomediastinal silhouette is unremarkable.The lungs are clear.There are no pleural effusions. | No acute cardiopulmonary abnormalities are identified. No specific evidence of infection. |
Generate impression based on medical findings. | Male 59 years old Reason: r/o infection History: confusion, wbc 22 Right internal jugular central venous catheter tip now terminates at cavoatrial junction.Questionable focal airspace opacity in the lingula.No pleural effusion or pneumothorax.The cardiomediastinal silhouette is normal. | Questionable focal airspace opacity in the lingula, repeat PA and lateral would be of value.These findings were relayed to Dr. Tibrewal at 10:15 on 6/20/2015 via telephone. |
Generate impression based on medical findings. | Reason: Evaluate for PNA History: Pt fell at home, more weak than usual, hx of PNA Moderate cardiomegaly with pacemaker leads in place and dense calcification in the mitral annulus, and dense coronary artery calcification, unchanged from previous.No evidence of pulmonary edema, pneumonia or pleural effusions.Old fracture deformity of the left fifth rib. | Moderate cardiomegaly with no acute findings. |
Generate impression based on medical findings. | Clinical question: Status post cavernoma bleed. Signs and symptoms: Cavernoma. Pre-and post-enhanced brain MRI:Diffusion-weighted images are negative.There is a focus of susceptibility indeed a right centrum semi-ovale with minimal blooming. On T2 weighted images the lesion has characteristic appearance of a cavernous malformation with a rim and internal septations of T2 hypointensity and loculated internal T2 hyperintensity as well as mild surrounding hemosiderin staining parenchyma. There is no evidence of surrounding edema or convincing evidence of hemorrhage. This mass abuts the ventricular wall. This lesion measures approximately 10 x 6.5-mm in transaxial dimensions.On susceptibility MRI series # 901 images 66 through 73 there is suggestion of an additional small cavernoma in the anterior tip of the left temporal lobe measuring at 6-mm in transaxial dimensions. This finding cannot be confirmed with certainty on any of the other MRI sequences.Flair and T2-weighted images demonstrate few tiny foci of hyperintensity in the subcortical and periventricular white matter, a single focus in the posterior limb of left internal capsule and left pos. Although nonspecific this appearance in proper clinical setting could represent chronic small vessel ischemic strokes.Unremarkable cerebral cortex, cortical sulci, ventricular system, CSF spaces and brain myelination otherwise.Post-enhanced images demonstrate no evidence of abnormal enhancement and including the right hemispheric cavernoma. Signal void of major intracranial arterial branches are identified. | 1.Negative diffusion weighted images.2.A right centrum semi-ovale cavernoma measuring at 10 x 6.5-mm without evidence of hemorrhage or surrounding edema.3.A second 6mm cavernoma suspected in the anterior left temporal lobe on susceptibility MR images as detailed.4.Few punctate foci of flair hyperintensity in subcortical/periventricular white matter, posterior limb of left internal capsule and left paramedian pons which could represent minimal chronic small vessel ischemic strokes in proper clinical setting. |
Generate impression based on medical findings. | Female, 43 years old.Reason: chest pain post-op despite pain medications, rule out PE History: chest pain, pain with inspiration Mild left base subsegmental atelectasis which can be an indicator of pulmonary embolism or infection/aspiration.Elsewhere, the lungs are unremarkable.Heart size normal. | Left lower lobe subsegmental atelectasis which is nonspecific but can be seen in the setting of infection, aspirated secretions or pulmonary embolism. |
Generate impression based on medical findings. | 57-year-old male with cirrhosis of unknown etiology. Please assess lung nodule and questionable liver mass and evaluate for abdominal abscess This study is limited due to lack of IV contrast. Especially focal liver lesions cannot be optimally evaluated.CHEST:LUNGS AND PLEURA: Left lower lobe subsegmental atelectasis. Bibasilar dependent atelectasis. Trace amount of pleural effusion bilaterally.MEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: Cirrhotic liver. There is an ill-defined hypodense area near the dome of the liver measuring 2.9 x 2.4 cm on image number 52, series number 4. Lack of IV contrast precludes optimal evaluation of this lesion, however, given the patient's cirrhosis this lesion is suspicious for hepatocellular carcinoma.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Bilateral mild caliectasis is likely secondary to significant distended bladder. Both ureters are normal in size.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: Small amount of ascites.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: Significantly distended bladder.LYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: Bilateral lytic, destructive lesions in both iliac bones.OTHER: No significant abnormality noted | No evidence of chest mass or intra-abdominal abscess.Cirrhosis and portal hypertension.Focal hypodensities in the liver. It cannot be characterized at the level of IV contrast, however, given the presence of cirrhosis, this lesion is suspicious for hepatocellular carcinoma.Bilateral iliac bone lytic lesions concerning for metastatic disease or multiple myeloma.Significantly distended bladder, of uncertain etiology. |
Generate impression based on medical findings. | Right upper extremity numbness, memory loss and right-sided headache x 6 weeks. No intracranial mass or mass-effect. There is mild global parenchymal volume loss which appears within normal limits for age. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific. Brain parenchyma is otherwise unremarkable for age. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. There is mild mucosal thickening throughout the paranasal sinuses. Mastoid air cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. | 1. Examination is essentially unremarkable for age. No intracranial mass or mass effect. Mild global parenchymal volume loss.2. Scattered T2/FLAIR hyperintensities in the white matter, which are nonspecific and may represent mild small vessel ischemic change I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Mesothelioma Interval removal of 2 of the right chest tubes, the single apical chest tube otherwise persist with a minimal residual hydropneumothorax with suspected loculation and fluid along the lateral inferior wall.Basilar atelectasis without additional discrete new right intrapulmonary abnormality. Left lung remains essentially clearCardiac and mediastinal contours of also improved with decreased cardiac size, now borderline in overall dimension | 2 right chest tubes |
Generate impression based on medical findings. | Female, 25 years old.Reason: history of possible PE History: chest pressure Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. |
Generate impression based on medical findings. | 75-year-old male with thrombocytopenia, evaluate. LIVER: Increase in hepatic parenchymal echogenicity with coarsened echotexture. No focal hepatic lesions. Hepatic length measures 14.4 cm. The main portal vein is patent with normal hepatopetal flow with a velocity of 20 cm/s. GALLBLADDER/BILIARY TRACT: The gallbladder wall measuring 3 mm. Sludge is noted within the gallbladder. The common bile duct measures 3.7 mm in diameter. No choledocholithiasis. No intra or extrahepatic biliary ductal dilatation identified.PANCREAS: Portions of the pancreas are obscured by bowel gas with visualized portions normal in appearance.SPLEEN: The spleen measures 9.6 cm and has a normal echotexture.KIDNEYS: The kidneys have normal corticomedullary differentiation. The right kidney measures 10.3 cm with no hydronephrosis. The left kidney measures 11.1 cm with no hydronephrosis. OTHER: Right pleural effusion is noted. | 1.Increase in hepatic parenchymal echogenicity with coarsened echotexture consistent with fatty liver/hepatic parenchymal dysfunction. No hepatic mass or ductal dilatation identified.2.Gallbladder sludge without evidence of acute cholecystitis.3.Right pleural effusion. |
Generate impression based on medical findings. | Age: 41 yearsGender: FemaleReason for Study: Reason: 41 year old f shortness of breath x 2 weeks. Hx of Hodgkins Lymphoma age 23 History: shortness of breath, chest tightness, no fever chills, wt loss Cardiac size is normal.Mild superior retraction of the hila compatible with post radiation changes.Calcified hilar mediastinal lymph nodes compatible with prior granulomatous disease.The lungs are clear.No pleural effusions. | No acute cardiopulmonary abnormalities are identified. No specific evidence of infection. |
Generate impression based on medical findings. | Male, 73 years old.Reason: evaluate CIED History: pacemaker Left basilar linear scarring, lungs otherwise unremarkable.Heart size upper normal.Left subclavian dual-chamber pacemaker, one lead projected over the right atrial appendage and the other along the pulmonary outflow tract. | Pacemaker leads described above, the exam otherwise unremarkable except for left basilar scarring or subsegmental atelectasis. |
Generate impression based on medical findings. | Female, 46 years old.Reason: cough fever History: fever Cardiomediastinal silhouette is within normal limits.No focal air space abnormality. No significant pleural effusions.Mild scoliosis. | No acute cardiopulmonary abnormality or interval change. |
Generate impression based on medical findings. | Male, 27 years old.PICC placement. Left upper extremity PICC tip in the superior vena cava. No pneumothorax. The cardiomediastinal silhouette is within normal limits. No focal airspace opacity, significant pleural effusion, or pneumothorax. | PICC tip in the superior vena cava without acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Age: 64 yearsGender: MaleReason for Study: Reason: chest pain History: cp that radiates to the back Stable Carty mediastinal silhouette.Postsurgical changes in the right midlung.Mild nonspecific basilar interstitial opacities similar to the prior exam.No new pulmonary opacities noted. | No acute cardiopulmonary abnormalities identified without interval change. |
Generate impression based on medical findings. | Male, 47 years old.Postoperative. Left ventricular assist device. Median sternotomy hardware noted. Unchanged radiographic appearance of the left ventricular assist device.Left PICC tip in the left subclavian vein.Stable cardiac enlargement. Otherwise unremarkable cardiomediastinal silhouette.Left lower lobe atelectasis and possible small pleural effusion. No new pulmonary opacities. | Postoperative findings without significant interval change. |
Generate impression based on medical findings. | Age: 52 yearsGender: MaleReason for Study: Reason: Increased O2 requirement History: SOB There are decreased lung volumes.There is probable cardiac enlargement although the left heart and port or is obscured by a moderate-sized left pleural effusion and left basilar consolidation/atelectasis.Mild scarring/discoid atelectasis at the right lung base.Right subclavian/innominate vascular stent noted. | Moderate-sized left pleural effusion and left basilar consolidation/atelectasis. |
Generate impression based on medical findings. | Female, 72 years old.Lung cancer surveillance. Right chest port change in position. No visible pulmonary nodules or masses. No pleural fluid. Left hemithorax postsurgical changes. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Female; 43 years old. Reason: large gallstone on bedside US, eval for acute cholecystitis History: RUQ abdominal pain LIVER: The liver measures 18.2 cm in length. Liver contour is smooth. The parenchyma demonstrates a coarsened echotexture. No worrisome hepatic mass is identified. There is no ascites.The main portal vein is patent with hepatopetal flow and a peak velocity of 0.27 m/sec.BILIARY TRACT: Gallbladder is not distended. There is a 2 x 3 cm shadowing stone within the body of the gallbladder. The gallbladder wall is thickened measuring 6 mm. There is no pericholecystic fluid. Sonographic Murphy's sign was not elicited. The common duct measures 3 mm in diameter. There is no intrahepatic biliary ductal dilatation.PANCREAS: The pancreas is not well visualized due to overlying bowel gas.SPLEEN: The spleen measures 7.9 cm in length.RIGHT KIDNEY: Right kidney measures 10.5 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. OTHER: The left kidney measures 10.1 cm in length. The cortex is normal in echogenicity. There is no hydronephrosis, shadowing renal stone, or worrisome mass identified. | Cholelithiasis without acute inflammation or ductal dilatation. Coarsened echogenic liver parenchyma suggestive for fatty infiltration/parenchymal dysfunction without mass. No ascites.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Male, 61 years old.Reason: swan placement History: swan placement Support devices unchanged with Swan-Ganz catheter tip in the pulmonary artery.Stable cardiac enlargement.Right pleural effusion and right basilar opacity similar to the prior exam.No new pulmonary opacities identified. | Support devices unchanged. Stable cardiopulmonary appearance with right pleural effusion and associated right basilar opacities. |
Generate impression based on medical findings. | Male, 71 years old.Chest pain. Hypoxia. Question volume overload. Cardiomegaly with enlargement of the central pulmonary vasculature consistent with pulmonary hypertension unchanged. Chronic pleural scarring and parenchymal atelectasis/scarring bilaterally, but no signs of a superimposed acute process. No specific evidence of pulmonary edema. | No acute pulmonary abnormality. Chronic findings consistent with pulmonary hypertension, scarring and atelectasis. |
Generate impression based on medical findings. | Patient with persistent pain in right shoulder, status post dog attack 3 months ago. Dog pulled on distal arm and shook patient. No direct attack at the shoulder joint. ROTATOR CUFF: Supraspinatus, infraspinatus, and teres minor tendons appear normal. The muscles likewise appear normal. There is a 3 to 4 mm tiny focus of signal intensity within the superior fibers of the subscapularis tendon, which may represent a small interstitial tear but this is of questionable clinical significance. The subscapularis muscle otherwise appears normal.SUPRASPINATUS OUTLET: Mild osteoarthritis affects the acromioclavicular joint. We see no fluid in the subacromial/subdeltoid bursa.GLENOHUMERAL JOINT AND GLENOID LABRUM: Glenohumeral joint alignment is normal. We see no joint effusion. Given the limitations of a nonarthrogram study, the glenoid labrum and articular cartilage appear normal. Small cysts within the anteromedial and posterolateral humeral head may be degenerative in etiology.BICEPS TENDON: Given the limitations of nonarthrogram study, the tendon of the long head of the biceps appear normal. There is small amount of fluid in the tendon sheath which is not necessarily of any clinical significance. | 1.Tiny focus of signal intensity in the superior fibers of the subscapularis tendon may represent small interstitial tear, but this is of questionable clinical significance and the remainder of the rotator cuff is unremarkable.2.Mild osteoarthritis of the acromioclavicular joint and other findings as described above. |
Generate impression based on medical findings. | Female, 72 years old.Reason: malignant neoplasm of supraglottis and lung RUL and middle lobe History: s/p lung resection wedge vats 11/25/15 Basilar scar like opacities and small pleural effusions, improved compared to the prior examination.Status post wedge resections.Unremarkable mediastinal contours and cardiac silhouette. | Improvement in atelectasis following surgery last month, with no new findings. |
Generate impression based on medical findings. | 80 years Male (DOB:5/30/1935)Reason: memory loss History: memory lossPatient History: pt c/o headaches, dizziness, memory loss, patient moving on some scansPregnancy Assessment: Patient signed.PROVIDER/ATTENDING NAME: TIA R KOSTAS TIA R KOSTAS The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.On susceptibility imaging there are punctate signal hyperintensities along the hippocampi bilaterally but more on the right versus the left side.There is a mild degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | 1.Periventricular and subcortical white matter lesions of a mild degree are nonspecific. At this age they are most likely vascular related. 2.Microhemorrhages are suspected to be present along the hippocampi bilaterally - right more than left. |
Generate impression based on medical findings. | 39-year-old female with left knee pain. Medial joint line pain after ACL reconstruction. Patient motion artifact limits examination.MENISCI: The medial meniscus appears intact. The lateral meniscus appears intact.ARTICULAR CARTILAGE AND BONE: There are tricompartmental osteophytes. No full-thickness or near full-thickness articular cartilage defects are identified. There is partial-thickness articular cartilage degeneration along the lateral facet of the femoral trochlea.LIGAMENTS: Note is made of postsurgical changes of prior ACL graft repair. The mid substance and distal fibers of the ACL graft are indistinct suggesting graft disruption. The PCL appears intact. The MCL and LCL appear intact. EXTENSOR MECHANISM: The quadriceps tendon appears intact. Note is made of postsurgical changes within the patellar tendon likely reflecting graft harvesting for the aforementioned ACL repair. The patellar tendon appears intact.ADDITIONAL | 1. Disruption of the mid substance and distal fibers of the ACL graft reconstruction.2. Small knee joint effusion.3. Osteoarthritic changes of the knee. |
Generate impression based on medical findings. | 35-year-old female with recently diagnosed breast cancer, concern for abscess post biopsy. There is heterogeneous amount of fibroglandular tissue in both breasts.Marked parenchymal enhancement is noted bilaterally, a limitation to the exam. The enhancing index right breast mass at 1:00 measures 3.9 x 3.7 x 3.8 cm. Medial to the mass there is a peripherally enhancing collection measuring 2.3 x 1.3 x 1.7 cm with adjacent skin thickening and central susceptibility artifact suggesting clip migration to within the collection.Two possible satellite lesions posterior to the index mass measure up to 1.5 and 0.9 cm respectively. There is an enlarged heterogeneously enhancing right axillary lymph node which measures 2.9 x 1.9 cm.In the left breast there is a 1.1 x 0.7 x 1.1 cm small enhancing mass at 12:00. At 11:00 in the left breast an additional small enhancing 1.0 x 0.9 x 1.1 cm mass is noted.Note is made of a likely hepatic cyst. | 1. Superficial loculated enhancing fluid collection/abscess medial to the index cancer with adjacent inflammatory changes as described above. The biopsy clip appears to have migrated into the collection. 2. Index right breast cancer measures up to 3.9 cm and has two possible satellite lesions present posteriorly. As well, a suspicious right axillary lymph node is seen. MRI directed ultrasound is recommended. 3. Small enhancing masses in the upper left breast for which second look ultrasound is recommended. Findings were discussed with Dr. Jaskowiak.BIRADS: 6 - Known cancer.RECOMMENDATION: T - Take Appropriate Action - No Letter. |
Generate impression based on medical findings. | 35 years Male (DOB:12/23/1980)Reason: assess for structural abnormality History: twitching of left handPROVIDER/ATTENDING NAME: ADIL JAVED ROBERT T KAVITT The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. Incidental noted is made of a 5 mm pineal region cystic type lesion.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate mild mucosal thickening. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | There are no MRI findings which can explain the patient's hand twitching. There is no intracranial mass lesion appreciated. |
Generate impression based on medical findings. | Female, 62 years old.Left thoracentesis evaluate for pneumothorax. No pneumothorax.Interval decrease in left pleural fluid volume.Improving pulmonary edema.Hair braids project over the upper thorax.Vascular embolization coils project over the mediastinum. | No pneumothorax. Improving pulmonary edema. |
Generate impression based on medical findings. | Age: 64 yearsGender: MaleReason for Study: Reason: 64 yo m w/ pancreatitis History: shortness of breath Enteric tubes with their tips beyond the margin of the image.Right central venous catheter with its tip at the SVC/RA junction.There decreased lung volumes with basilar opacities compatible with pleural effusions and atelectasis.No new pulmonary opacities identified. | No acute cardiopulmonary abnormalities are identified. |
Generate impression based on medical findings. | 64 year old female with a history of AL Amyloidosis. She is referred for cardiac MRI to rule out cardiac involvement. Left VentricleThe left ventricle is normal in size and function. The overall LV ejection fraction is 77%, the LV end diastolic volume index is 68 ml/m2 (normal range: 65+/-11), the LVEDV is 151 ml (normal range 109+/-23), the LV end systolic volume index is 16 ml/m2 (normal range 18+/-5), the LVESV is 35 ml (normal range 31+/-10), the LV mass index is 62 g/m2 (normal range 67+/-11), and the LV mass is 139 g (normal range 114+/-24). There are no regional wall motion abnormalities present. The basal anteroseptum is 14mm, slightly increased from 11mm. Stable enhancement of the basal to mid inferior wall. No intracardiac thrombus.Left AtriumThe left atrium is dilated.Right VentricleThe right ventricle is normal in function. The overall RV ejection fraction is 69%, the RV end diastolic volume index is 72 ml/m2 (normal range 69+/-14), the RVEDV is 160 ml (normal range 110+/-24), the RV end systolic volume index is 22 ml/m2 (normal range 22+/-8), and the RVESV is 49 ml (normal range 35+/-13). Right AtriumThe right atrium is dilated.Aortic ValveThe aortic valve opens widely and there is no significant aortic regurgitation.Mitral ValveThe mitral valve opens widely and there is mitral regurgitation, estimated to be mild.Pulmonic ValveThe pulmonic valve opens widely. There is no significant pulmonic regurgitation.Tricuspid ValveThe tricuspid valve opens widely. There is mild tricuspid regurgitation.AortaThere is a left sided aortic arch with a common origin of the innominate and left common carotid arteries. The thoracic aorta is normal in size.Pulmonary VeinsAll four pulmonary veins drain normally into the left atrium.Pulmonary ArteryThe main pulmonary artery is normal in size. Venous AnatomyThe SVC and IVC are normal in size and drain normally into the right atrium. PericardiumThere is a small pericardial effusion.Extracardiac FindingsStable hepatic and left renal cyst. The pancreas was not included in this field of view. | 1. The left ventricle is normal in size and function. There is stable enhancement of the basal to mid inferior wall, atypical for amyloid. This may be related to prior scar from myocarditis. In this clinical setting with small pericardial effusion and slight increase in wall thickness, the possibility of localized cardiac amyloid cannot be excluded.3. The right ventricle is normal in function. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | 27 years old Male. Reason: tachycardia History: tachycardia. There is no evidence of acute infiltrate, pleural effusion or pneumothorax. The cardiac silhouette is normal. | Unremarkable study. |
Generate impression based on medical findings. | Shortness of breath in dialysis patient. Evaluate volume status. Normal cardiomediastinal silhouette size.Unchanged position of left sided central venous catheter and right sided vascular stents.No focal pulmonary opacity, pleural effusion or pneumothorax. | No evidence of pulmonary edema. |
Generate impression based on medical findings. | Male, 65 years old.Reason: insure nothing retained from pulled pa catheter History: none No evidence of retained PA catheter fragment. Right jugular introducer sheath in upper SVC. Other findings stable. | No evidence of retained PA catheter fragment. |
Generate impression based on medical findings. | Female, 32 years old.Pleuritic chest pain and shortness of breath for one month. No fever, cough or congestion. Evaluate for bony abnormality, cardiomegaly or pulmonary edema. Low lung volumes. Normal heart size. No focal pulmonary opacity or signs of pulmonary edema.Please note that chest technique has a limited sensitivity for osseous pathology including fracture or dislocation. If clinically warranted, dedicated bone technique films of the are of interest would be recommended. | Markedly low lung volumes, likely related to patient's bodily habitus, though an intra-abdominal process could not be excluded by plain film. No acute pulmonary abnormality. |
Generate impression based on medical findings. | Female, 81 years old.Reason: patient with sudden change in BP, assess for pneumothorax History: hypotension Endotracheal tube terminates approximately 6 cm from the carina. Enteric tube side port is again at the gastroesophageal junction. Study limited by rightward rotation. Low lung volumes makes detailed cardiopulmonary assessment difficult. Basilar pleuroparenchymal opacities, not substantially changed. Unchanged heart size. No pneumothorax. | Basilar pleuroparenchymal opacities, not substantially changed. |
Generate impression based on medical findings. | Female, 65 years old.Port placement. Right chest port tip terminates in the SVC. No significant pneumothorax. Streaky right basilar opacity most consistent with subsegmental atelectasis. Blunting of the left costophrenic angle consistent with scarring/atelectasis versus a trace pleural effusion. Surgical fixation of the right clavicle in near-anatomic alignment without evidence of hardware complication. | Right chest port without evidence of complication.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Female, 57 years old.Reason: re-evaluate pneumothorax History: none, trend pneumothorax Right pleural effusion and persistent right basilar airspace opacity suggestive of infection or aspiration.Mild basilar edema and small left pleural effusion.Right apical pneumothorax improved, now 15 mm previously 22 mm over the apex.Right subclavian catheter, tip at right atrial level. | Improvement in right pneumothorax with persistent right pleural effusion and right basilar consolidation. |
Generate impression based on medical findings. | 76-year-old male with prostate cancer CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: Atherosclerotic changes of the thoracic aorta.Calcified subcarinal and right hilar lymph nodes, all unchanged.Coronary artery calcifications.Moderate hiatal hernia, unchanged.CHEST WALL: No significant abnormality notedABDOMEN:LIVER, BILIARY TRACT: No significant abnormality notedSPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: There is a 2.5 x 2.8 cm left adrenal mass (series 3 3, image 104), new since the prior examination.KIDNEYS, URETERS: Bilateral renal cysts are unchanged.RETROPERITONEUM, LYMPH NODES: Index left para-aortic lymph node (series 3, image 121) measures 3.4 x 3.0 cm (previously 4.6 x 4.2 cm). Previously noted periaortic node, just above the iliac bifurcation (series 3, image 139) measures 19 x 15 mm (previously 20 x 12 mm).Although these reference nodes are stable or smaller, the para-aortic lymph nodes have become confluent, encasing the infrarenal aorta. Additionally, there is new retroperitoneal lymphadenopathy more superiorly. An enlarged periaortic lymph node adjacent to the SMA (series 3, image 106) is new since the prior examination.These nodes cause new mass-effect on the IVC and on the renal vasculature.BOWEL, MESENTERY: Colonic diverticulosis without evidence of acute inflammationBONES, SOFT TISSUES: Presumed T9 hemangioma, unchanged. However, ill defined sclerotic lesions have developed in the vertebral bodies T4, T8, and L1, not seen on the prior study and concerning for metastatic lesions.PELVIS:PROSTATE, SEMINAL VESICLES: Not visualizedBLADDER: No significant abnormality noted.LYMPH NODES: Right common iliac node (series 3, image 147) measures 9 x 8 mm (previously 10 x 9 mm).Conglomerate left external iliac node (series 3, image 186) measures 5.4 x 2.1 cm. When measured using the same technique, this measured 4.1 x 2.0 cm on the prior examination (prior study series 3, image 184).Other external iliac nodes have also increased in the interval. BOWEL, MESENTERY: Colonic diverticulosis.BONES, SOFT TISSUES: Sclerotic osseous lesions, as described above.Worsening anasarca is seen in the lower abdomen and lower extremities. | Interval worsening of retroperitoneal and pelvic lymphadenopathy, new adrenal mass, and new osseous lesions, compatible with progression of disease. |
Generate impression based on medical findings. | Papillary thyroid carcinoma status post resection with palpable lymph nodes RIGHT LOBE: Status post thyroidectomy without massLEFT LOBE: Status post thyroidectomy without massISTHMUS: Status post thyroidectomy without massPARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Stable benign-appearing cervical lymph nodes bilaterally. 0.6 x 0.4 x 1.2 cm hypoechoic lymph node within the subcutaneous tissues left level 5 periarticular region corresponding to the palpable lesion.OTHER: No significant abnormality noted. | Hypoechoic normal sized lymph node within the subcutaneous tissues left level 5 periarticular region corresponding to the clinically palpable focus. Its appearance favors a benign reactive etiology over metastatic focus. Would recommend special attention to this lymph node on future surveillance scans. Otherwise stable examination without evidence for metastatic focus. Benign-appearing regional lymph nodes again noted and unchanged. |
Generate impression based on medical findings. | The pituitary gland is not enlarged and there is no evidence of gross mass lesions, although the assessment is limited by the lack of intravenous contrast. The pituitary stalk lies in the midline. The suprasellar cistern, optic chiasm, cavernous sinuses and intracranial portions of the optic nerves appear to be intact. There is no evidence of intracranial hemorrhage or acute infarct. However, there are scattered T2 hyperintense lesions in the periventricular and subcortical white matter, a few of which are flame shaped in configuration. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The skull and extracranial soft tissues are unremarkable. There is minimal mucosal thickening of the bilateral maxillary sinuses. | 1. Limited non-contrast examination without evidence of gross mass lesions in the pituitary gland. 2. Several lesions in the periventricular and subcortical white matter likely represent demyelinating lesions, although these are incompletely characterized due to the lack of intravenous contrast.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Female, 47 years old.Reason: short of breath History: short of breath Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. No specific evidence of infection or edema. |
Generate impression based on medical findings. | Age: 22 yearsGender: FemaleReason for Study: Reason: Eval for catheter remaining post central line removal History: chest discomfort Interval removal of a right central venous catheter.No residual catheter can identified.Decreased lung volumes with stable cardiomediastinal silhouette.No new pulmonary opacities identified.Redemonstration of scoliosis of the thoracic spine. | Interval removal of a right central venous catheter. No evidence of catheter remnant identified. No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Increasing white count Persistent decreased lung volumes with mildly prominent right hilar region, possibly secondary to enlarged pulmonary artery and patient rotation. Changes are associated with overlying bullet fragment and is explicitly stable compared to prior.No discrete superimposed focal air space abnormality, however mild chronic appearing interstitial findings cannot entirely be excluded yet difficult to exclude due to overlying bedding material | Essentially unchanged mild decreased lung volumes without definite superimposed acute abnormality. Close serial imaging however will be important to exclude a subtle abnormality possibly obscured by limitations described |
Generate impression based on medical findings. | 43-year-old female with a history of a right mastectomy for IDC/DCIS in 2011. She has a family history of breast cancer in her paternal grandmother diagnosed in her 80s and paternal aunt diagnosed in her 60s. Status post right mastectomy and reconstruction.There is scattered fibroglandular tissue in the left breast.Mild parenchymal enhancement is noted in the left breast.No abnormal enhancement is seen in the left breast or in the reconstructed right breast. No abnormal lymph nodes are identified in either axillary region. | No MRI evidence for malignancy. BIRADS: 1 - Negative.RECOMMENDATION: ND - Routine Diagnostic Mammogram. |
Generate impression based on medical findings. | Shortness of breath Small to moderate left pleural effusion with ill-defined retrocardiac opacity, possibly representing atelectasis and compression from the moderately enlarged heart versus aspiration or infection. Serial imaging is needed. Decreased lung volumes | Questionable left lower lobe partial consolidation versus atelectasis associated with a small effusion. Pneumonia cannot be excluded in the appropriate setting |
Generate impression based on medical findings. | Male, 64 years old.Reason: Febrile History: Febrile Lines and tubes are unchanged. Improvement in patchy left basilar opacity. Small left pleural effusion again noted. No new focal lung consolidation. Unchanged heart size. No pneumothorax. | Improvement in patchy left basilar opacity which may represent aspiration and/or atelectasis. Small left pleural effusion again noted. |
Generate impression based on medical findings. | 30-year-old female with cavernous malformation. Redemonstrated are numerous supratentorial and infratentorial foci of susceptibility hypointensity, which are not significantly changed, none of which demonstrate perilesional edema. There is an unchanged 4 mm transverse dimension enhancing lesion along the right falx cerebri which is unchanged in appearance. There is no evidence of acute intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The skull and scalp soft tissues are unremarkable. There is a right maxillary sinus retention cyst, unchanged. | 1.Numerous supratentorial and infratentorial cavernous malformations have not significantly changed, none demonstrating perilesional edema. No evidence of acute intracranial hemorrhage or acute infarct.2.An unchanged 4 mm wide enhancing lesion along the right falx cerebri likely represents a meningioma. |
Generate impression based on medical findings. | 32 year old female with known descending aortic dissection now with abdominal pain/vomiting. Please evaluate for acute process. CHEST:LUNGS AND PLEURA: Moderate (right greater than left) pleural effusion with overlying compressive atelectasis/consolidation.MEDIASTINUM AND HILA: Reidentification of type A aortic dissection with adjacent pericardial hematoma appearing similar to prior study with stable mass effect on the right atrium. Stable intramural hematoma within the proximal aorta.Presumed post surgical changes at the aortic root are unchanged.Intimal flap extends into the left common carotid artery and down the descending thoracic aorta, unchanged.CHEST WALL: Median sternotomy wires. ABDOMEN: LIVER, BILIARY TRACT: Fatty infiltration of the liver.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: Subtle asymmetrically decreased enhancement of the left kidney, which is perfused by the false lumen of the aorta.RETROPERITONEUM, LYMPH NODES: Vascular findings: The intimal flap extends into the celiac artery and the common hepatic artery the SMA and supplied by the true lumen. The right renal artery supplied by the true lumen; the left renal artery and IMA are supplied by the false lumen.The dissection flap extends into the left common iliac artery.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Anasarca. OTHER: Small amount of free fluid. | 1. Stable type A aortic dissection as detailed above. Intramural hematoma at the proximal aorta as well as pericardial hematoma are unchanged.2. Subtle asymmetrically decreased enhancement of the left kidney, which is perfused by the false lumen of the aorta.3. Stable right greater than left pleural effusions and bibasilar atelectasis and consolidations. |
Generate impression based on medical findings. | Female, 35 years old.Reason: eval ETT, lung fields History: s/p MVR, TVR Endotracheal tube terminates approximately 5 cm from the carina. Mediastinal drains noted. Swan-Ganz catheter terminates within the right pulmonary artery. Epicardial lead is noted. Mild pneumomediastinum, likely postoperative in nature. Patient status post MVR and TVR. Mild basilar atelectasis. Cardiomegaly unchanged. No large pneumothorax. | Expected appearance status post MVR and TVR. |
Generate impression based on medical findings. | Reason: pna History: cough, sob Unremarkable cardiac and mediastinal silhouette. Streaky bronchial thickening and airspace opacity in the lower lobes bilaterally, suggestive of aspiration.Healed rib deformities on the right. | Bilateral lower lobe airspace opacity and bronchiolitis, suggestive of aspiration and infection.The findings were discussed with Dr. Carter in the ED at the time of reporting. |
Generate impression based on medical findings. | Age: 68 yearsGender: MaleReason for Study: Reason: hx Vfib arrest, post extubation History: as above Left IJ venous catheter has been removed.Decreased lung volumes with stable cardiomediastinal silhouette.The lungs are clear.No pleural effusions. | No acute cardiopulmonary abnormality identified. |
Generate impression based on medical findings. | Female 20 years old Reason: Evaluate for disc herniation History: L4/L5 level midline pain with SLR+ b/l Five lumbar type vertebral bodies are presumed to be present. The lumbar spine is in normal alignment, with a normal lumbar lordosis. The vertebral body and disk heights are well-maintained. No focal marrow signal abnormality is appreciated. The conus medullaris on sagittal imaging is at the L1-2 level.T12-L1: There is no significant compromise to spinal canal or neural foramina.L1-L2: There is no significant compromise to spinal canal or neural foramina.L2-L3: There is no significant compromise to spinal canal or neural foramina.L3-L4: There is no significant compromise to spinal canal or neural foramina.L4-5: There is no significant compromise to spinal canal or neural foramina.L5-S1: There is a mild disc bulge and small right paracentral protrusion, but no significant compromise to spinal canal or neural foramina. Mild facet arthropathy. | Mild degenerative disc findings at L5-S1 without significant spinal canal or foraminal stenosis. No other findings are seen to account for the patient's symptoms. |
Generate impression based on medical findings. | Male, 78 years old.Reason: intubated, h/o aspiration History: intubated h/o aspiration Right-sided airspace opacity and diffuse nodular interstitial disease unchanged.Median sternotomy, heart size likely normal.ET tube tip approximately 4 cm above the carina.NG tube tip in proximal stomach.Right PICC, tip at cavoatrial junction. | Unchanged pulmonary opacities suggestive of infection and possible aspiration. ET tube tip approximately 4 cm above the carina. |
Generate impression based on medical findings. | Clinical question: Left pulsatile tinnitus. Signs and symptoms: Left pulsatile tinnitus. Pre-and post-enhanced brain MRI:Negative diffusion weighted images.Examination demonstrates few tiny foci of flair hyperintensity in the periventricular and subcortical white matter of bilateral cerebral hemispheres which appear more conspicuous compared to prior study. Although nonspecific considering patient's stated age of 71 findings are suspected of very mild chronic nonhemorrhagic small vessel ischemic strokes.The anatomical morphology as well as the signal intensity of brain parenchyma otherwise remains within normal on all MRI sequences. Unremarkable study cortex, cortical sulci, ventricular system, CSF spaces and brain myelination.Signal void of major intracranial arterial branches are identified. There is uniformly smaller size of basilar artery which is believed to be secondary to presence of prominent posterior communicating arteries. Unremarkable calvarium and soft tissues of the scalp. Unremarkable orbits, paranasal sinuses and mastoid air cells.Post-enhanced images demonstrate no detectable abnormal enhancement of brain parenchyma, leptomeninges, calvarium or the orbits.Pre-and post-enhanced brain MRA:The visualized aortic arch and the origins of major vessels are unremarkable.Unremarkable brachial cephalic and bilateral subclavian arteries.Patent and unremarkable bilateral vertebral arteries and including their origins.Patent bilateral common carotid arteries, bilateral internal carotid arteries as well as the external carotid arteries.Minimal vascular lumen irregularity of the left upper cervical internal carotid artery which could represent atherosclerotic disease. There is no evidence of vascular lumen compromise. | 1.Pre-and post-enhanced brain MRI demonstrate no evidence of acute intracranial process. Findings suggestive of very mild nonhemorrhagic chronic small vessel ischemic strokes.2.Unremarkable neck MRA. |
Generate impression based on medical findings. | 69-year-old male with history of carcinoid tumor status post left lower lobe lobectomy CHEST:LUNGS AND PLEURA: New right middle lobe air space opacity extending from the hilum to the pleura, likely scarring/atelectasis. Postoperative appearance of left lower lobe with left basilar consolidation/atelectasis (improved from prior) with trace left effusion. MEDIASTINUM AND HILA: No significant abnormality noted.CHEST WALL: No significant abnormality noted.ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.PANCREAS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Post operative appearance with left basilar consolidation/atelectasis, improved from prior. New right middle lobe scarring/atelectasis. |
Generate impression based on medical findings. | Female, 65 years old.Reason: s/p pacemaker implantation History: symptomatic bradycardia Cardiac leads terminating in expected location of the right atrium and right ventricle. Mild interstitial pulmonary edema, slightly increased from last study. Question of very small pleural effusions. No pneumothorax. Unchanged cardiomegaly given slightly lordotic orientation. | Cardiac leads, as above. No pneumothorax. Slight increase in mild interstitial pulmonary edema. |
Generate impression based on medical findings. | Pneumonia, cough Mildly interval increasing interstitial and patchy airspace changes now more pronounced in all 4 quadrants and on the right. Underlying mild nonspecific cardiac megaly, moderate effusions and hardware are otherwise unchanged. | Concern for increasing diffuse mild to moderate edema superimposed upon previously observed scarring and nonspecific changes |
Generate impression based on medical findings. | Female, 49 years old.Shortness of breath question evidence of infection. Mild globular cardiomegaly unchanged. Low normal lung volumes. No focal airspace opacities, pleural fluid or pneumothorax. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | 76-year-old male with a hypermetabolic sellar mass and metastatic thyroid cancer to the posterior aspect of T9. BRAIN/PITUITARY:No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. The ventricles are within normal limits in size and configuration. The expected location of the pituitary gland, there is a mass that measure 1.4 x 1.3 cm sagittally and 2.1 cm coronally that appears to have slightly expanded the sellar space and superiorly comes near but does not abut the optic apparatus. No apparent mass effect is seen on adjacent structures. A small portion of the mass enters the left cavernous sinus and abuts the cavernous carotid, however without narrowing. The pituitary stalk is displaced rightward. No calcifications are visualized. The lesion is isodense to brain matter on T1/T2 and demonstrates heterogeneous enhancement.Further, there is a small T2 hyperintense frontal lesion measuring 8 x 9 mm (series #28, image 16) that is nonenhancing. This likely represents a prominent perivascular space adjacent to an area of chronic small vessel ischemic disease.Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter without restricted diffusion, which are nonspecific, but compatible with chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. Further, there is mild volume loss without a lobar predominant atrophy pattern.No abnormal meningeal enhancement. Major flow-voids are preserved.Orbits are grossly within normal limits. Paranasal sinuses and mastoid cells are clear. Bone marrow signal and extracranial soft tissues are within normal limits. THORACIC/LUMBAR SPINE:There is redemonstration of the known thyroid metastasis centered posterior to the T9 vertebral body, though extending from T8 to T10. The lesion measures 45 x 39 mm in the sagittal plane (series #4, image 17). The mass appears centered between the left posterior elements of T8 and T9. The mass appears to invade the posterior elements of T8, T9, and T10 and vertebral bodies of T8 and T9. Anteriorly the mass severely narrows the spinal canal and the cord appears dysmorphic in appearance. Laterally, there is medial left rib invasion of T8, T9, and T10. The mass also abuts/infiltrates in the right medial T9 rib. There is obliteration of the T8-T9 and T9-T10 neuroforaminal spaces on the left.There is a separate lesion concerning for metastasis centered within the body of T10.Five lumbar type vertebral bodies are presumed to be present. Vertebral body heights are within normal limits. There is trace anterolisthesis of L4 on L5 trace retrolisthesis of L5 on S1. There is multilevel facet disease worse at L4-L5 and L5-S1. Bone marrow signal is benign. The conus medullaris is normal in position at the L1-L2 level.The right thyroid mass is redemonstrated. Further, there is a moderate left pleural effusion. There is extensive fatty deposition within the paraspinal and retroperitoneal spaces. | 1. 1.4 x 1.3 sellar mass without abutment of the (distal likely represents a macroadenoma, or less likely a metastasis.2. Redemonstration of known thyroid metastasis posterior to the T9 vertebral body with invasion as above.3. A separate lesion concerning for metastasis is centered in the T10 vertebral body.4. There is a left pleural effusion. |
Generate impression based on medical findings. | History of papillary serous carcinoma status post brain biopsies. There are postoperative findings related to right occipital lobe biopsy without evidence of residual enhancing lesion. There is residual surrounding confluent T2 hyperintensity. There is an unchanged enhancing dural based lesion that measures up to 5 mm along the inferior surface of the left tentorium, near the apex. There are punctate foci of susceptibility effect without associated enhancement in the right cerebellum, left frontal lobe periventricular white matter, and medial right occipital lobe. There is no evidence of acute infarct. There are scattered foci of cerebral white matter T2 hyperintensity without associated enhancement. There is mild diffuse cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There are bilateral lens implants. The skull and scalp soft tissues are grossly unremarkable. There is fluid in the left maxillary and right sphenoid sinuses and scattered paranasal sinus mucosal thickening. There is also fluid within the bilateral mastoid air cells. | 1. Post-treatment findings in the right occipital lobe, without evidence of recurrent tumor. 2. An unchanged enhancing dural based lesion that measures up to 5 mm along the inferior surface of the left tentorium may represent a meningioma or metastasis.3. Punctate foci of susceptibility effect without associated enhancement in the right cerebellum, left frontal lobe periventricular white matter, and medial right occipital lobe are nonspecific and may represent chronic microhemorrhages, perhaps related to amyloid angiopathy.4. Findings suggestive of acute sinusitis and mastoiditis. |
Generate impression based on medical findings. | Dyspnea, evaluate for pneumonia. Perihilar bronchial thickening consistent with history of asthma. No consolidation or effusion. Normal cardiomediastinal silhouette. | No acute abnormalities. No evidence of pneumonia. |
Generate impression based on medical findings. | Male, 83 years old.Shortness of breath Low lung volumes.Cardiomediastinal silhouette is unchanged.Bibasilar opacities consistent with left greater than right pleural effusions with adjacent atelectasis is not significantly changed accounting for differences in positioning. Bibasilar airspace opacities appears similar to the prior exam.Loculated retrosternal fluid collection. | Bilateral airspace opacities, atelectasis, and pleural effusions without significant interval change. |
Generate impression based on medical findings. | 36-year-old male history testicular cancer status post orchiectomy, chemo for increased RPLN, also history renal transplant due to Alport syndrome. CHEST:LUNGS AND PLEURA: No significant abnormality notedMEDIASTINUM AND HILA: No significant abnormality notedCHEST WALL: No significant abnormality notedABDOMEN: The exam is not sensitive detecting lesions in the solid organs due to lack of intravenous contrast. Given that limitation, the following observations are made:LIVER, BILIARY TRACT: Cholelithiasis without obvious biliary dilatation redemonstrated. No definite focal liver lesions.SPLEEN: No significant abnormality notedPANCREAS: No significant abnormality notedADRENAL GLANDS: No significant abnormality notedKIDNEYS, URETERS: Small atrophic kidneys consistent with a history of chronic medical renal disease.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality notedOTHER: No significant abnormality notedPELVIS:PROSTATE, SEMINAL VESICLES: No significant abnormality notedBLADDER: No significant abnormality notedLYMPH NODES: No significant abnormality notedBOWEL, MESENTERY: No significant abnormality notedBONES, SOFT TISSUES: No significant abnormality notedOTHER: Renal allograft left iliac fossa. External iliac artery aneurysms redemonstrated on the left, cephalad component measured on series 4 image 1704.3 x 3.5 cm. previously 4 x 3.4 CM. The aneurysm has a bilobed configuration best seen on coronal and its 65/130 with a larger proximal component with a maximal cross-sectional 4.5-cm is seen on image 64/130 which is essentially unchanged from the prior exam. The caudal component measures 2.3-cm in cross-section on the same coronal image is also essentially unchanged.Proximal to the aneurysms, the common iliac artery is ectatic and dilated up to 2.3 cm series 4 image 152, unchanged. | Comparison of coronal and axial images suggest only minimal if any increase in size of the bilobed left external iliac artery aneurysms.Cholelithiasis. |
Generate impression based on medical findings. | Male, 44 years old.CHF. Swan-Ganz catheter placement. Not significantly changed. Right jugular Swan-Ganz catheter has been advanced with tip now over the right pulmonary artery. Mediastinal drains again noted. No pneumothorax. | Swan-Ganz catheter advanced tip now over the right pulmonary artery. Stable predominantly right-sided pulmonary opacities may reflect edema or infection. |
Generate impression based on medical findings. | Age: 78 yearsGender: MaleReason for Study: Reason: s/p bronchoscopy History: hypoxia Motion limits sensitivity.Support devices unchanged.Stable cardiac mediastinal silhouette.Perihilar/basilar opacities are compatible with atelectasis, edema, pleural effusions. | Limited exam due to respiratory motion. Support devices unchanged. Stable cardiopulmonary appearance. |
Generate impression based on medical findings. | Male, 68 years old.Reason: sp prostatectomy, cb sigmoid perforation, remains intubated History: none Basilar atelectasis unchanged with small pleural effusions.ET tube tip approximately 5 cm above the carina.Left jugular catheter, tip in SVC. | ET tube tip approximately 5 cm above the carina. Unchanged basilar opacities. |
Generate impression based on medical findings. | Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. A few scattered punctate foci of T2 hyperintensities are noted in the subcortical frontal lobe white matter bilaterally. There is no abnormal intracranial enhancement. The cavernous sinuses appear to be intact. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The skull, paranasal sinuses, and scalp soft tissues are unremarkable. Orbits: There is a disconjugate gaze and apparent mild volume loss of the left lateral rectus. The globes otherwise appear to be intact. The optic nerves, chiasm, and tracts appear normal. There is no optic nerve sheath dilatation. The extraocular muscles are normal and symmetric with physiologic, homogeneous, and intense contrast enhancement. The lacrimal glands are symmetric and within normal limits for size. There is no evidence of orbital mass lesion or abnormal enhancement. | 1.Minimal punctate foci of T2 hyperintensities in the subcortical frontal lobe white matter bilaterally, but otherwise no specific findings to suggest a demyelinating process or acute infarct. 2.Apparent disconjugate gaze and mild volume loss of the left lateral rectus related to left abducens nerve palsy, but no discernible mass along the course of the abducens nerve or evidence of brainstem lesions. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | 51-year-old woman with history of cervical cancer. PELVIS:UTERUS, ADNEXA: There is abnormal intermediate T2 signal involving the left lateral cervix (501/40) with corresponding diffusion abnormality (806/328). This signal abnormality extends approximately 18 mm laterally into the parametrial fat beyond the ectocervix. Additionally, there is a small area of T2 signal abnormality along the right posterior cervix with loss of the ectocervical interface (601/30).Multiple uterine fibroids are noted.BLADDER: The bladder appears normal. There is no hydronephrosis.LYMPH NODES: No significant lymphadenopathy seen.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Peritoneal dialysis catheter noted in the abdomen. | 1.Cervical carcinoma with parametrial extension, left greater than right, as detailed above.2.No regional lymphadenopathy or hydroureter. |
Generate impression based on medical findings. | Male, 61 years old.Reason: catheter placement confirmation History: above Small lung volumes, otherwise unremarkable.Right jugular catheter, tip in SVC. | Right jugular catheter, tip in SVC. |
Generate impression based on medical findings. | 2-year-old male with oral aversion and vomiting. Evaluate for brainstem or posterior fossa lesion. There are scattered areas of periventricular white matter T2 hyperintensity, left more than right. There is otherwise a normal degree of myelination and the brainstem and cerebellum are unremarkable, however. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The corpus callosum is fully formed and intact. The brainstem and cerebellum are normal in appearance. The ventricles and basal cisterns are normal in size and configuration, albeit the left lateral ventricle is larger than the right. There is no midline shift or herniation. The major cerebral flow voids are intact. There is scattered mucosal thickening of the ethmoid air cells, right sphenoid sinus and right maxillary sinus. The orbits, skull and scalp soft tissues are grossly unremarkable. | Scattered areas of periventricular white matter T2 hyperintensity, left more than right, are nonspecific. Differential considerations include prior ischemia or infection in addition to terminal zones of myelination. The brainstem and cerebellum are unremarkable, however. I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report. |
Generate impression based on medical findings. | Male, 59 years old.Reason: IABP position, pulmonary edema History: CHF, IABP Left ICD stable.IABP marker slightly higher now at the level of aortic arch. No new pulmonary opacity or significant edema. | IABP marker slightly higher now at the level of aortic arch. |
Generate impression based on medical findings. | Female, 60 years old.Reason: picc line placement History: picc line Mild cardiomegaly.No specific evidence of infection or edema.Right PICC, tip in right subclavian. | PICC placement. Mild cardiomegaly. |
Generate impression based on medical findings. | Reason: infiltrate History: AMS Normal heart size with a retrocardiac hiatal hernia.No significant pulmonary abnormalities. | No acute abnormalities. |
Generate impression based on medical findings. | Male, 66 years old.Reason: presumed lung CA R mainstem bronchus, History: shortness of breath Right jugular catheter terminates in the cavoatrial junction.There is near complete collapse of the right lung, with rightward shift of the mediastinum, consistent with patient's known endobronchial lesion. No pleural effusion. | Near complete collapse of the right lung with rightward shift of the mediastinum, consistent with patient's known endobronchial lesion. This can be further evaluated with a contrast-enhanced CT of the chest.These findings were discussed with Dr. Philip Hoffman at 10:45 AM on 5/17/2016. |
Generate impression based on medical findings. | Male, 19 years old.Reason: Evidence of mediastinal masses/PNA/pulmonary edema? 19 YO male with a history of seizures and chronic pain History: Chest Pain Unremarkable mediastinal and cardiac silhouette.No significant pulmonary or pleural abnormalities. | No significant abnormality. |
Generate impression based on medical findings. | Male, 32 years old.Infectious. Volume loss again noted in the left hemithorax and left pleural thickening is not significantly changed. Stable cardiomediastinal silhouette. No focal airspace opacity, pleural effusion, or pneumothorax. | No acute cardiopulmonary abnormality. |
Generate impression based on medical findings. | Female, 55 years old.ETT position. Tubes and lines unchanged in position, ETT tip about 2.5 cm above the expected level of the carina. Basal atelectasis. Motion artifact. No pneumothorax. No specific signs of pulmonary edema. | ETT tip about 2.5 cm above the expected level of the carina. |
Generate impression based on medical findings. | Age: 21 yearsGender: MaleReason for Study: Reason: rule out pneumonia History: sickle cell voc crisis, low back, admisison The cardiomediastinal silhouette is unremarkable.No focal areas of consolidation.There are no pleural effusions. | No acute cardiopulmonary abnormalities identified without interval change. |
Generate impression based on medical findings. | Male, 31 years old.Reason:. Evaluate lung fields, r/o hemothorax History: trach - removed R subclavian IJ yesterday Right subclavian line has been removed. Other lines and tubes, unchanged. Mild diffuse pulmonary edema with patchy left basilar opacity again noted. No pneumothorax. Unchanged currently measuring. | No pneumothorax or right-sided pleural effusion. Mild pulmonary edema, as before. |
Generate impression based on medical findings. | Diagnosis: Other forms of epilepsy and recurrent seizures with intractable epilepsyClinical question: epilepsy presurgical evaluation. Epilepsy protocol 2. 1 mm thin cut. Please include 3 D T1 contrast and DTI is requested. Please contact Dr. Carina Yang for questions.Signs and Symptoms: Medically intractable right frontal epilepsyComments: Please include 3 D T1 contrast and DTI is requested. Please contact Dr. Carina Yang for questions. Thanks. | The CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma. The hippocampi are symmetric.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus. The left sigmoid sinus and left transverse sinus and in left jugular fossa are larger than their right counterparts.The visualized portions of the paranasal sinuses are clear. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact. | MRI of the brain is within normal limits. No etiology for the patient's known seizures is appreciated. |
Generate impression based on medical findings. | Encephalopathy, unspecified [G93.40], Reason for Study: ^Reason: Persistently encephalopathic with R gaze deviation and R sided weakness History: pls see above Multifocal scattered bihemispheric restricted diffusion lesions involving bilateral frontal, parietal temporal, left occipital bilateral basal ganglia and bilateral cerebellar hemisphere indicating acute ischemic infarct.There is also 53.7 mm (AP) x 30.2 mm (RL) x 15 mm (CC) sized left basal ganglia acute/subacute ICH with the surrounding edema and mass effects. There is midline shift toward the right side about 8 mm at the level of foramen of Monro measured on axial scan. Considering underlying multifocal acute ischemic infarcts, this hemorrhagic lesion could demonstrate hemorrhagic conversion.Underlying brain shows patch scattered bihemispheric periventricular white matter FLAIR/T2 high signal intensity lesions indicating nonspecific small vessel ischemic disease.The ventricles, sulci and cisterns are symmetric and unremarkable. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. Mucosal thickenings on bilateral maxillary sinuses, ethmoid sinuses, sphenoid sinus and frontal sinus. Bilateral mastoid air cells show opacifications. | 1. Multifocal supra and infratentorial ischemic infarctions.2. Left basal ganglia ICH with mass effects with midline shift toward right side, likely represent hemorrhagic conversion.3. Underlying non specific small vessel ischemic disease. |
Generate impression based on medical findings. | 61 year-old female with metastatic breast cancer status post two cycles of chemotherapy. Evaluate and compare to previous. CHEST:LUNGS AND PLEURA: Punctate left lower lobe nodule is unchanged (image 42; series 80213)MEDIASTINUM AND HILA: Reference precarinal lymph node has decreased minimally in size and currently measures 1.1 x 1.2 cm (image 36; series 2).CHEST WALL: Sclerotic foci in the sternum are compatible with metastases as noted previously.Numerous chest wall collaterals are seen on the right. The right subclavian vein is at least partially occluded and the right internal jugular vein is diminutive in size as noted previously.Bilateral breast implants and axillary node dissections.Right-sided port terminates in the SVC.ABDOMEN:LIVER, BILIARY TRACT: Reference liver lesions difficult to measure given indistinct borders but has probably increased slightly in size currently measuring 2.5 x 2.5 cm (image 61; series 3). Other lesions are similar to slightly increased in size.Cholecystectomy.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Reference gastrohepatic ligament lymph node (image 88; series 3) has equivocally increased in size and measures 1.2 x 1.3 cm.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: Small, nonenhancing cystic lesion expands the left T12-L1 neural foramen with smooth remodeling of the T12 vertebral body again noted, unchanged.OTHER: No significant abnormality noted.PELVIS:UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted. | Slight interval progression of disease. Reference measurements above. |
Generate impression based on medical findings. | Enlarged thyroid RIGHT LOBE MEASUREMENTS: 1.5 x 1.5 x 5.4 cmLEFT LOBE MEASUREMENTS: 1.5 x 1.5 x 4.5 cmISTHMUS MEASUREMENTS: 0.3 cmRIGHT LOBE: Diffusely heterogeneous gland. Right inferior hyperechoic thyroid nodule measuring 1.6 x 1.0 x 1.5 cm.LEFT LOBE: Diffusely heterogeneous gland.ISTHMUS: No significant abnormality noted.PARATHYROID GLANDS: No significant abnormality noted.LYMPH NODES: Small left cervical lymph node noted measuring 0.5 x 0.3 x 1.1 cm.OTHER: No significant abnormality noted. | Diffusely heterogeneous gland. Right inferior hyperechoic nodule, favor benign etiology. |
Generate impression based on medical findings. | Please evaluate cough. History of laryngeal carcinoma. Evaluate for metastases. LUNGS AND PLEURA: Moderately severe mainly upper lobe centrilobular emphysema.Scarring and surgical staples in the right lower lobe.Several nonspecific micronodules, unchanged, and no sign of metastases.MEDIASTINUM AND HILA: No significant lymphadenopathy.Extensive and severe coronary or a calcification.CHEST WALL: Degenerative abnormalities in the spine.UPPER ABDOMEN: Retention tacks from a prior gastrostomy, small nonspecific splenic hypodensities, and small left adrenal nodule, unchanged. | No change and no sign of metastases. |
Generate impression based on medical findings. | 55-year-old female. Cirrhosis. Screen for HCC. ABDOMEN:LIVER, BILIARY TRACT: Liver contour: Nodular consistent with a cirrhotic morphologyFeatures of portal hypertension: Small esophageal and perigastric varices, ascites, and borderline splenomegaly. Portal vein: Patent proximal to the TIPS.Hepatic artery: PatentHepatic vein: Middle and left are patent. Right vein not well visualized due to artifact from TIPS.Lesions: 9 x 9 mm lesion (image 23, series 10; previously 9 x 8 mm) in the right hepatic dome, arterial enhancement - faint; washout - no; peripheral rim enhancement - no.Interval placement of TIPS, patency of which cannot be evaluated due to shunt artifact. New peripheral wedge-shaped arterially enhancing foci at the distal end of the TIPS in the hepatic dome with persistent contrast enhancement on delayed phases and no corresponding T2 signal abnormality, likely a perfusion abnormality.SPLEEN: Borderline splenomegaly measuring 12 cm. 1.8-cm distal splenic artery aneurysm (series 3, image 20), unchangedPANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: Dilated retroperitoneal lymphatics, which may be due to cirrhosis and hypoalbuminemia, unchanged.BOWEL, MESENTERY: No significant abnormality noted.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: Small amount of abdominopelvic ascites. Small hiatal hernia with loculated pocket of fluid at the GE junction, unchanged. | 1.Stable nonspecific right hepatic dome lesion with enhancement characteristics that do not meet strict criteria for HCC. No new worrisome lesion.2.Interval TIPS placement, patency of which cannot be evaluated due to shunt artifact. Small amount of ascites.3.1.8 cm distal splenic artery aneurysm, unchanged. Consultation with IR for possible embolization is suggested. |
Generate impression based on medical findings. | Reason: eval for pathology History: desaturation on room air Unremarkable cardiac and mediastinal silhouette.No significant pulmonary or pleural disease.Presumed shunt catheter superimposed on the mediastinum. | No significant abnormalities. |
Generate impression based on medical findings. | Chiari malformation decompression follow up. Brain: There are stable postoperative findings related to Chiari decompression and fourth ventricular stenting. The cerebellum displays an unchanged morphology and signal characteristics. There is no evidence of intracranial hemorrhage, mass, or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits and paranasal sinuses are grossly unremarkable.Spine: There is a posterior disc-osteophyte complex, eccentric to the right at C6-7, which has increased in size and indents the spinal cord. Otherwise, there is no evidence of spinal cord signal abnormality or syrinx. There is no significant neural foramen stenosis. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. The paravertebral soft tissues are unchanged. | 1. Stable postoperative findings related to Chiari decompression and fourth ventricular stenting without evidence of syringohydromyelia.2. A posterior disc-osteophyte complex has increased in size and indents the spinal cord. |